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Acute perioperative pain

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https://www.readbyqxmd.com/read/28903493/editor-s-highlight-formulation-and-toxicology-evaluation-of-the-intrathecal-ayx1-dna-decoy-in-sprague-dawley-rats
#1
Julien Mamet, David C Yeomans, Tony L Yaksh, Donald C Manning, Scott Harris
The longevity of pain after surgery is debilitating and limits the recovery of patients. AYX1 is a double-stranded, unprotected, 23 base-pair oligonucleotide designed to reduce acute post-surgical pain and prevent its chronification with a single intrathecal perioperative dose. AYX1 mimics the DNA sequence normally bound by EGR1 on chromosomes, a transcription factor transiently induced in the dorsal root ganglia-spinal cord network following a noxious input. AYX1 binds to EGR1 and prevents it from launching waves of gene regulation that are necessary to maintain pain over time...
September 1, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28887250/analysis-of-patients-undergoing-major-lower-extremity-amputation-in-the-vascular-quality-initiative
#2
Joshua Gabel, Brice Jabo, Sheela Patel, Sharon Kiang, Christian Bianchi, Jason Chiriano, Theodore Teruya, Ahmed M Abou-Zamzam
BACKGROUND: Despite an aggressive climate of limb salvage and revascularization, 7% of patients with peripheral artery disease undergo major lower extremity amputation (LEA). The purpose of this study was to describe the current demographics and early outcomes of patients undergoing major LEA in the Vascular Quality Initiative (VQI). METHODS: The VQI amputation registry was reviewed to identify patients who underwent major LEAs. Patient factors, limb characteristics, procedure type, and intraoperative variables were analyzed by level of amputation...
September 5, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28882350/preoperative-norepinephrine-levels-in-cerebrospinal-fluid-and-plasma-correlate-with-pain-intensity-after-pediatric-spine-surgery
#3
Catherine E Ferland, Alexandre J Parent, Neil Saran, Pablo M Ingelmo, Anaïs Lacasse, Serge Marchand, Philippe Sarret, Jean A Ouellet
PURPOSE: Catecholamines were found to be involved in descending pain modulation and associated with perioperative pain. The purpose of the present study was to investigate the relationship between preoperative concentrations of catecholamines and postoperative pain intensity of pediatric patients. METHODS: Fifty adolescents with idiopathic scoliosis scheduled for elective spinal fusion surgery were enrolled in this prospective cohort study. Preoperative plasma and cerebrospinal fluid (CSF) samples were collected and analyzed by mass spectrometry...
September 2017: Spine Deformity
https://www.readbyqxmd.com/read/28876654/ileosigmoid-knotting-a-zimbabwean-case-series
#4
C Mbanje, S Mungazi, A J V Maunganidze
BACKGROUND: Ileosigmoid knotting is a rare cause of intestinal obstruction with a rapidly progressive course, for which expedient surgical intervention is required to avoid mortality. METHOD: A combined retrospective and prospective analysis was performed on 16 patients operated on at PGH with an operative diagnosis of ileosigmoid knotting between February 2011 and April 2016. Data inclusive of demographics, time to presentation and surgery, preoperative diagnostic accuracy, incidence of septic shock and mortality was collected...
June 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28876572/haemoperitoneum-secondary-to-snake-bite
#5
S Rahim
BACKGROUND: Literature supports that very rarely the venom of "Hemotoxic Snake" (Russell's Vipers) affect haemostasis by secreting thrombin-like enzyme which promotes formation of unstable clots. Such clots could lead to fibrin deposition in micro circulation that in turn consume platelets and coagulation factors (consumption coagulopathy). Clinical presentation is mainly spontaneous bleeding and coagulopathy. In this case the significant effects of altered coagulation were observed in retropetitoneum and the patient presented in casuality as acute abdomen...
September 2017: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28860845/dexmedetomidine-in-perioperative-acute-pain-management-a-non-opioid-adjuvant-analgesic
#6
REVIEW
Chaoliang Tang, Zhongyuan Xia
Many nociceptive, inflammatory, and neuropathic pathways contribute to perioperative pain. Although opioids have long been a mainstay for perioperative analgesia, other non-opioid therapies, and dexmedetomidine, in particular, have been increasingly used as part of a multimodal analgesic regimen to provide improved pain control while minimizing opioid-related side effects. This article reviews the evidence supporting the preoperative, intraoperative, and postoperative efficacy of dexmedetomidine as an adjuvant, and the efficacy of intravenous, spinal canal, and nerve block analgesia with dexmedetomidine for perioperative acute pain treatment...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28853044/consensus-statement-for-clinical-pathway-development-for-perioperative-pain-management-and-care-transitions
#7
REVIEW
Alan D Kaye, Erik M Helander, Nalini Vadivelu, Leandro Lumermann, Thomas Suchy, Margaret Rose, Richard D Urman
The perioperative surgical home (PSH) model has been created with the intention to reduce costs and to improve efficiency of care and patient experience in the perioperative period. The PSH is a comprehensive model of care that is team-based and patient-centric. The team in each facility should be multidisciplinary and include the input of perioperative services leadership, surgical services, and support personnel in order to provide seamless care for the patient from the preoperative period when decision to undergo surgery is initially made to discharge and, if needed after discharge from the hospital, until full recovery is achieved...
August 29, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28820803/perioperative-breast-analgesia-a-qualitative-review-of-anatomy-and-regional-techniques
#8
Glenn E Woodworth, Ryan M J Ivie, Sylvia M Nelson, Cameron M Walker, Robert B Maniker
Breast surgery is exceedingly common and may result in significant acute as well as chronic pain. Numerous options exist for the control of perioperative breast pain, including several newly described regional anesthesia techniques, but anesthesiologists have an insufficient understanding of the anatomy of the breast, the anatomic structures disrupted by the various breast surgeries, and the theoretical and experimental evidence supporting the use of the various analgesic options. In this article, we review the anatomy of the breast, common breast surgeries and their potential anatomic sources of pain, and analgesic techniques for managing perioperative pain...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28796754/perioperative-patient-beliefs-regarding-potential-effectiveness-of-marijuana-cannabinoids-for-treatment-of-pain-a-prospective-population-survey
#9
Yury Khelemsky, Andrew T Goldberg, Yasmin L Hurd, Gary Winkel, Allen Ninh, Lucia Qian, Anna Oprescu, Jeffrey Ciccone, Daniel J Katz
BACKGROUND AND OBJECTIVES: Cannabinoids have an expanding presence in medicine. Perioperative patients' perceptions of the effectiveness of these compounds, and acceptance if prescribed for pain, have not been previously described. Our primary objective was to describe patients' beliefs regarding the potential effectiveness of cannabinoids for the treatment of acute and chronic pain, as well as gauge patient acceptance of these compounds if prescribed by a physician. In addition, demographic and pain history data were collected to elucidate the predictors of the aforementioned patient attitudes...
September 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28795967/the-perioperative-surgical-home-a-new-role-for-the-acute-pain-service
#10
Michael P Zaccagnino, Angela M Bader, Christine N Sang, Darin J Correll
No abstract text is available yet for this article.
October 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28763103/the-lack-of-analgesic-use-oligoanalgesia-in-small-animal-practice
#11
REVIEW
B T Simon, E M Scallan, G Carroll, P V Steagall
Oligoanalgesia is defined as failure to provide analgesia in patients with acute pain. Treatment of pain in emergencies, critical care and perioperatively may influence patient outcomes: the harmful practice of withholding analgesics occurs in teaching hospitals and private practices and results in severe physiological consequences. This article discusses the prevalence, primary causes, species and regional differences and ways to avoid oligoanalgesia in small animal practice. Oligoanalgesia may be addressed by improving education on pain management in the veterinary curriculum, providing continuing education to veterinarians and implementing pain scales...
August 1, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/28751024/preoperative-pregabalin-or-gabapentin-for-acute-and-chronic-postoperative-pain-among-patients-undergoing-breast-cancer-surgery-a%C3%A2-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
REVIEW
Ajit S Rai, James S Khan, Jasneet Dhaliwal, Jason W Busse, Stephen Choi, P J Devereaux, Hance Clarke
BACKGROUND AND OBJECTIVE: Breast cancer surgery is associated with acute and chronic pain. We sought to systematically evaluate the effects of gabapentin and pregabalin on postoperative pain among patients undergoing breast cancer surgery. DATABASES AND DATA TREATMENT: We searched MEDLINE, EMBASE, CENTRAL, Web of Science, and ProQuest from the inception of each database to November 2015. We included studies enrolling adult patients undergoing breast cancer surgery who were randomly assigned to preoperative gabapentin or pregabalin versus placebo or active control and assessed acute (≤24 h) or chronic (≥2 months) pain...
October 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28718036/paravertebral-blocks-reduce-narcotic-use-without-affecting-perfusion-in-patients-undergoing-autologous-breast-reconstruction
#13
Elizabeth B Odom, Nili Mehta, Rajiv P Parikh, Ryan Guffey, Terence M Myckatyn
BACKGROUND: Autologous breast reconstruction offers excellent long term outcomes after mastectomy. However, maintaining adequate postoperative analgesia remains challenging. Use of paravertebral blocks (PVBs) reduces postoperative narcotic use and length of stay, and enhanced recovery protocols with mixed analgesia methods are gaining popularity, but few studies have explored the intraoperative effects of these interventions. METHODS: Patients who underwent abdominally based autologous breast reconstruction between 2010 and 2016 were compiled into a retrospective database...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28708040/anterior-lumbar-discectomy-and-fusion-for-acute-cauda-equina-syndrome-caused-by-recurrent-disc-prolapse-report-of-3-cases
#14
Kimberly-Anne Tan, Mathew D Sewell, Yma Markmann, Andrew J Clarke, Oliver M Stokes, Daniel Chan
There is a lack of information and consensus regarding the optimal treatment for recurrent disc herniation previously treated by posterior discectomy, and no reports have described an anterior approach for recurrent disc herniation causing cauda equina syndrome (CES). Revision posterior decompression, irrespective of the presence of CES, has been reported to be associated with significantly higher rates of dural tears, hematomas, and iatrogenic nerve root damage. The authors describe treatment and outcomes in 3 consecutive cases of patients who underwent anterior lumbar discectomy and fusion (ALDF) for CES caused by recurrent disc herniations that had been previously treated with posterior discectomy...
July 14, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28671869/prognostic-value-of-neutrophil-to-lymphocyte-ratio-and-risk-factors-for-mortality-in-patients-with-stanford-type-a-aortic-dissection
#15
Kursad Oz, Taner Iyigun, Zeynep Karaman, Ömer Çelik, Ertan Akbay, Okan Akınc, Okan Akınc, Korhan Erkanli
BACKGROUND: Neutrophil to lymphocyte ratio (NLR) is a prognostic predictor in a wide range of cardiovascular disease. Acute aortic dissection (AD) is an uncommon but fatal cardiovascular disease. In this study, we investigated both prognostic factors in patients with AD and whether NLR can be a predictor for mortality. Methods: We analyzed retrospectively the data of 57 patients with AD who had undergone emergent surgery in our hospital and included 128 consecutive patients with chest pain admitted to the emergency room as a control group...
June 30, 2017: Heart Surgery Forum
https://www.readbyqxmd.com/read/28655354/perioperative-systemic-steroid-for-rapid-recovery-in-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis-of-randomized-trials
#16
REVIEW
Chen Yue, Rong Wei, Youwen Liu
BACKGROUND: Perioperative systemic steroid administration for rapid recovery in total knee and hip arthroplasty (TKA/THA) is an important and controversial topic. We conducted this systematic review and meta-analysis to evaluate the overall benefits and harms of perioperative systemic steroid in patients undergoing TKA and THA. METHODS: A comprehensive search was performed on PubMed, OVID, and Web of Science databases, and a systematic approach was carried out starting from the PRISMA recommendations...
June 27, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28641358/-pain-treatment-after-thoracic-surgery
#17
Holger Hendrix, Vladimir Kamlak, Georgi Prisadov, Katrin Welcker
The treatment of pain after thoracic surgery is a challenge and takes place in the individual clinics mostly according to clinic internal standards. It exists no currently valid S3 guideline for the treatment of acute perioperative and posttraumatic pain. For an effective pain treatment as well individual pain experience as the pain intensity of the various thoracic surgical procedures must be considered. Regular pain assessment with appropriate methods and their documentation form the basis for adequate and adapted pain therapy...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#18
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28620916/ketamine-does-not-enhance-the-quality-of-recovery-following-laparoscopic-cholecystectomy-a-randomized-controlled-trial
#19
E T Moro, I M P S S Feitosa, R G de Oliveira, G F P Saraiva, R Rosalino, V P Marossi, J A Bloomstone, L H C Navarro
BACKGROUND: Ketamine has been used as part of the multimodal analgesia technique in the acute perioperative period. The effect of perioperative intravenous small-dose ketamine on the quality of recovery from the patient point-of-view has not been assessed. We hypothesized that low-dose ketamine would enhance recovery following laparoscopic cholecystectomy under total intravenous anesthesia. METHODS: One hundred thirty five patients undergoing laparoscopic cholecystectomy were enrolled in this randomized, double-blind placebo-controlled trial...
August 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28619696/postoperative-pain-management-in-spanish-hospitals-a%C3%A2-cohort-study-using-the-pain-out-registry
#20
Mauricio Polanco-García, Jaume García-Lopez, Neus Fàbregas, Windfried Meissner, Margarita M Puig
Pain after surgery remains a problem worldwide, although there are no published data on postoperative outcomes in Spain. We evaluated 2,922 patients on the first day after surgery in 13 tertiary care Spanish hospitals, using the PAIN-OUT questionnaire. The aims were to: assess postoperative outcomes and anesthetic/analgesic management in Orthopedics (ORT) and General Surgery (GEN) patients; explore the influence of the analgesic therapy on outcomes and opioid requirements; evaluate and compare outcomes and analgesic management according to surgical procedure...
June 12, 2017: Journal of Pain: Official Journal of the American Pain Society
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